腹腔镜辅助远端胃癌根治术学习曲线研究  

Learning Curve of Laparoscopy-assisted Radical Distal Gastrectomy for Gastric Cancer

作　　者：朱纯超[1] 汤佳音[1] 赵刚[1] 徐佳[1] 郁丰荣[1] 曹晖[1] 

机构地区：[1]上海交通大学医学院附属仁济医院普外科,上海200127

出　　处：《中国微创外科杂志》2013年第12期1105-1108,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 探讨腹腔镜辅助远端胃癌根治术的学习曲线.方法 回顾分析2010年12月-2012年12月由同一术者完成的120例腹腔镜辅助远端胃癌根治手术的临床资料.按手术先后次序分为3组（A、B、C组各40例）,比较各组术中情况（手术时间、术中出血量、淋巴结清扫总数、中转开腹例数）及术后恢复情况（肛门排气时间、术后住院时间、并发症例数）.结果 与A组相比,B、C组手术时间短[A、B、C组分别为（287.8±34.9）、（200.6±21.2）、（201.8±27.7）min,F=125 012,P=0.000],术中出血量少[A、B、C组分别为（143.8±67.2）、（68.8±27.8）、（67.5±27.2）ml,F=38.018,P=0.000],淋巴结清扫数量多[A、B、C组分别为（18.3±3.4）、（25.8±4.6）、（26.3±4.9）个,F=43.047,P=0.000].B、C组之间差异均无显著性（P〉0.05）.3组肛门排气时间、术后住院时间、并发症发生率差异无显著性（P〉0.05）.结论在进行40例手术后,可完成腹腔镜辅助远端胃癌根治手术的学习曲线.Objective To investigate the learning curve of laparoscopy-assisted radical distal D2 gastrectomy for gastric cancer. Methods Retrospective analysis was carried out on the clinical data of 120 patients undergoing laparoscopy-assisted radical distal gastrectomy from December 2010 to December 2012 in our department. The patients were divided into three groups （group A, B and C, with 40 cases in each group） by operative sequence. The operation time, blood loss, conversion rate to open surgery, the number of lymph nodes resected, postoperative aerofluxus time, hospital stay, postoperative complication rate were compared among the 3 groups. Results The operation time of group B and group C was shorter than that of group A [ （287.8 ± 34.9） min, （200.6 ± 21.2） rain, （201.8 ± 27.7） min for group A, B and C respectively, F = 125. 012, P = 0. 000] ; the blood loss of group B and group C was less than that of group A [（143.8±7.2）ml, （68.8±27.8）ml, （67.5 ±27.2）ml for group A, B and C respectively, F= 38.018, P =0.000] ; the number of lymph nodes resected in group B and group C was more than that in group A [ （18.3 ± 3.4）, （25.8±4.6）, （26.3 ±4.9） for group A, B and C respectively, F=43.047, P=0. O00]; no significant difference was found between group B and group C （ P 〉 0. 05 ） ; no significant difference was found in exhaust time, postoperative hospital stay and complication rates among the three groups （ P 〉 0. 05 ）. Conclusion The learning curve of laparoscopy-assisted radical distal gastrectomy for gastric cancer can be accomplished after the practice of 40 cases of surgery.

关 键 词：胃癌 腹腔镜 手术 学习曲线 

分 类 号：R735.2[医药卫生—肿瘤]